Advancing the health of the population is not only vital to increasing residents’ quality of life, but necessary to ensure the overall success of a community. Health is a product of multiple social factors including education, housing, employment, transportation, and environment. Understanding these factors and their influence on public health is critical to community health improvement.

The City of Worcester Division of Public Health (WDPH), as the lead agency of the Central Massachusetts Regional Public Health Alliance (CMRPHA), UMass Memorial Medical Center, and Fallon Health led a comprehensive Community Health Assessment (CHA) effort to improve the health of the Greater Worcester area. The CHA was conducted in partnership with two other agencies: the YWCA of Central Massachusetts, whose expertise in community engagement was leveraged for much of the qualitative data collection; and Central Massachusetts Regional Planning Commission (CMRPC), whose data management expertise was utilized for secondary data aggregation.

The 2015 Greater Worcester Community Health Assessment (CHA) aims to provide a comprehensive portrait of the region’s health status as well as assets and needs as they relate to health.
The 2015 Greater Worcester Community Health Assessment was conducted to fulfill several overarching goals, specifically to:

  • Identify the issues impacting the health of the community through a collaborative health planning process;
  • Engage the community to identify shared priorities, goals, objectives, and strategies for moving forward in a cohesive and coordinated way;
  • Meet best practices for the 21st century community health improvement through maintaining health department standards as set by the Public Health Accreditation Board (PHAB);
  • Serve as a community health needs assessment and community benefit planning tool for UMass Memorial Medical Center and Fallon Health, fulfilling Schedule H/Form 990 IRS and Massachusetts Attorney General reporting guidelines, and;
  • Provide the foundation for the 2016 Community Health Improvement Plan, a strategic plan for the Central MA Regional Public Health Alliance and Healthy Greater Worcester, CHNA-8.

This CHA focuses on the municipalities that comprise the CMRPHA, including the towns of Grafton, Holden, Leicester, Millbury, Shrewsbury, and West Boylston and the City of Worcester. Focusing the CHA on this geographic area facilitates aligning the hospital, health department, local agencies, and the Community Health Network Area (CHNA) in health improvement efforts.

Methods
This CHA utilizes the Mobilizing for Action through Planning and Partnerships (MAPP) framework to guide the assessment process. This approach includes methods that are designed to maximize community engagement. The MAPP framework includes six phases: 1) Organizing for Success, 2) Visioning, 3) Four MAPP Assessments, 4) Identifying Strategic Issues, 5) Formulating Goals and Strategies, and 6) Action. This report focuses on Phases 1-4 of the process, which lays the groundwork for the implementation phase of developing and carrying out the Community Health Improvement Plan. Primary data collection included:

  • 24 stakeholder interviews and 23 focus groups totaling 221 participants from CEOs to community organizations to youth groups from throughout the region.
  • 1,250 respondents completed the CHA Public Survey conducted to assess the community’s needs and strengths with regards to healthy living.
  • 219 surveys from the ongoing Worcester Free Clinics Coalition survey process gathered information on health care access.
  • “Sticky note” exercises conducted at multiple community events throughout the region gathered opinions about what makes a community health.
  • 30 individuals participated in Lunch & Learn sessions to discuss current strengths, weaknesses, and opportunities for improvement of the local public health system.
  • 33 members of the Advisory Committee completed a survey as a part of the Local Public Health System and Forces of Change Assessment.

Secondary data was used to describe the socio-demographic and health profiles of the CMRPHA. Data sources include the U.S. Bureau of the Census; Behavioral Risk Factor Surveillance System; Massachusetts Department of Public Health’s MassCHIP (Massachusetts Community Health Information Profile) system; mortality and birth records; Essential School Health Services reports from local school districts, and; other national, state, county, and town datasets. Many additional existing reports, including the Regional Youth Health Survey, augmented secondary data collection.

Results
The CHA Public Survey results identified the CMRPHA’s top seven indicators of a healthy community. Ranked highest to lowest, they are as follows:

  1. Low crime/safe neighborhoods
  2. Good jobs and healthy economy
  3. Opportunities for physical activity
  4. Good schools
  5. Access to health care
  6. Clean environment
  7. Access to healthy food

The CHA Advisory Committee identified nine priorities. Priorities were set in order to concentrate efforts, drive collective impact, and focus discussions in developing the 2016 Community Health Improvement Plan. These priorities are not ranked, but rather are presented in alphabetical order:

  1. Access to Care
  2. Access to Healthy Food
  3. Cultural Competency
  4. Economic Opportunity
  5. Mental Health
  6. Physical Activity
  7. Racism and Discrimination
  8. Safety
  9. Substance Abuse

Next Steps
Findings and priorities identified in the Greater Worcester Community Health Assessment will be published and presented to the community and will serve as the foundation of the 2016 Greater Worcester Community Health Improvement Plan (CHIP).

Through a community input and planning process, the CHIP will outline data-driven priority goals, identify evidence-based practice approaches, measurable objectives and strategies for each identified priority “Domain” area. The CHIP serves as the Greater Worcester Regional road map to the future health of the region and intended to be a living document that will be reassessed annually.

Working Groups for each CHIP Domain will be established including stakeholders and residents.

Alignment for Collective Impact: Community Benefits programs and initiatives at UMass Memorial Medical Center and Fallon Health focus on addressing health disparities and improving access to care for medically underserved and vulnerable groups of all ages. These programs are designed to respond to identified needs and address health disparities among ethnically diverse, disadvantaged and vulnerable populations identified through a Community Health Needs Assessment conducted every three years. By design, UMass Memorial Medical Center and Fallon Health Community Benefits Plans will closely align with the CHIP.

The CHIP will be utilized to encourage other key organizations, stakeholders, community groups and residents to engage in the overall health and well-being of the seven communities of CMRPHA.

To read the full report, view it here.

CHA cover